Cellulite is a term applied to a skin condition which mainly afflicts post-pubertal women. To some extent, it is a secondary sex characteristic but there is also an associated inflammatory reaction with moderate fibrosis (scarring). Cellulite can occur in any individual but is prominent in heavy set and especially obese women. Cellulite is generally recognized by the dimpled appearance of the skin and is particularly apparent on thick skin, such as the thigh area. This dimpling effect is also commonly called the "mattress phenomenon" because of the periodic dimpling and bulging of the skin resembling a stuffed mattress. Mattressing becomes more apparent when the skin is pinched between the fingers and this "pinch test" may be used as a gross determination of the severity of cellulite.
Histologically, the appearance of cellulite is determined by the sex-linked distribution of female fat. Cellulite appears when subcutaneous or adipose tissue projects upwardly as rounded chambers into the overlying dermis. These locules of fat deeply indent the dermis and approach the surface, creating the mattress phenomenon. In men, the junction between the dermis and subcutaneous tissue is flat without deep extensions of fat into the overlying dermis.
From a cosmetic point of view, cellulite is a source of concern and distress to women. Lumpy-bumpy skin is unpleasant to feel and is often tender. This concern and distress are particularly true among overweight women, among whom more than fifty percent exhibit some degree of cellulite. Large sums of money are spent every year combating this problem. A large array of devices and chemical treatments are used. Conventional physical methods of treating cellulite include electrical stimuli, heat, massage using so-called cellulite gloves, and other mechanical interventions. In addition, many substances, mostly of a botanical origin are touted to control cellulite. These diverse approaches are in use worldwide as home treatments or in numerous spas and salons specializing in cellulite treatment. Some of the pharmacological approaches include caffeine, nicotinates and a host of vasodilators and counter-irritants, such as methyl salicylate.
The long list of therapies is testimony to the lack of beneficial effects from any of these assorted treatments. None have been shown to be effective in reducing cellulite. Only intense exercise and weight loss are modestly beneficial in some cases.
In view of the deficiencies of the prior art methods, it would be desirable to have a method of treating cellulite which is safe, convenient and effective.
Retinoids (e.g. Vitamin A and its derivatives) are known to have a broad spectrum of biological activity. More specifically, these substances affect cell growth, differentiation and proliferation. Vitamin A is essential for maintaining growth and differentiation of epithelial tissues. Retinoids act as a general growth stimulant to many kinds of cells found in skin and elsewhere. They stimulate fibroblasts to make collagen and ground substance, the main constituents of the dermis. Retinoids induce formation of new blood vessels. The metabolic activity of other cell types is also increased. Retinoids have been extensively and effectively used to treat acne vulgaris and a variety of chronic dermatoses, including psoriasis.
Retinoids are being intensively investigated for the prophylaxis of various cancers. They can eradicate actinic keratoses and premalignant tumors arising on photodamaged skin. For a review of developments in retinoid therapy, see Pawson, B.A. et al., "Retinoids at the Threshold: Their Biological Significance and Therapeutic Potential," Journal of Medicinal Chemistry 25:1269-1277 (1982). A discussion of retinoids in research and clinical medicine can be found in the publication of a symposium held in Geneva: J.H. Saurat, Editor, "Retinoids: New Trends in Research and Therapy," Karger Publishing Co. (1985).
Certain retinoids, in particular, Vitamin A acid, also known as tretinoin or retinoic acid, have proved to be very effective in acne as set forth in my U.S. Pat. No. 3,729,568. Other topical uses of Vitamin A acid, reviewed by Thomas, J.R. et al., "The Therapeutic Uses of Topical Vitamin A Acid," Journal of American Academy of Dermatology 4:505-516 (1981), include treatment of senile comedones, nevus comedonicus, plantar warts, pesudofolliculitis of the beard, keratoacanthoma, solar keratoses, keratosis palmaris et plantaris, Darier's disease, ichthyosis, psoriasis, acanthosis nigricans, lichen planus, molluscum contagiosum, reactive perforating collagenosis, melasma, geographic tongue, Fox-Fordyce disease, cutaneous metastatic melanoma, and keloids or hypertrophic scars.
My U.S. Pat. Nos. 4,603,146; 4,877,805 and 4,888,342 disclose methods for treating sundamaged human skin topically with Vitamin A acid and other retinoids in a vehicle in concentrations not excessively irritating to the skin. Topical retinoic acid causes the skin, particularly human facial skin, to substantially regain and maintain its firmness, turgor and elasticity by stimulating the production of new collagen bundles which comprise the fibrous structural network of skin. Other effects include angiogenesis, increased density of resident dermal cells, such as fibroblasts, mast cells and macrophages. As a result of these various activities, skin which has been badly damaged by sunlight exhibits a great improvement in appearance and in structure. Moreover, some of the ameliorating effects of Vitamin A acid in chronic disorders have been attributed to anti-inflammatory effects.